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What`s new in vulvar cancer research and treatment?

Research is being done to find new ways to prevent and treat cancer of the vulva. There are some promising new developments.

Oncogenes and tumor suppressor genes

Scientists are learning more about how certain genes called oncogenes and tumor suppressor genes control cell growth and how changes in these genes cause normal vulvar cells to become cancerous. This information is already being used to develop new drugs that counteract the effects of these gene changes. The ultimate goal of this research is gene therapy. Gene therapy involves replacing the damaged genes in cancer cells with normal genes in order to stop the abnormal behavior of these cells.

HPV vaccines

Vaccines for preventing and treating vulvar and cervical cancer are being developed and tested.

Some of these vaccines are meant to prevent infection with certain types of HPV by boosting the body’s immunity to them. Two HPV vaccines, Gardasil and Cervarix, are available. Both vaccines are able to prevent infection with HPV types 16 and 18 and prevent pre-cancerous changes in the cervix. Studies have shown that Gardasil can also prevent anal, vulvar, and vaginal cancers caused by HPV types 6 and 11. Other preventive vaccines are also under study.

Some vaccines being studied are intended to help the immune systems of women with HPV infections destroy the virus and cure the infection before a cancer develops.

Other vaccines are meant to help women who already have a cancer or pre-cancer. These vaccines attempt to produce an immune reaction to the parts of the virus (E6 and E7 proteins) that specifically contribute to the abnormal growth of cancer cells. It is hoped that this immunity will kill the cancer cells or stop them from growing. A vaccine of this type was tested in women with grade 3 vulvar intraepithelial neoplasia (VIN3) that tested positive for HPV-16. Most women treated had their VIN lesions shrink, and in some the lesions even went away completely.

Drug treatment

There have been case reports of using drugs known as targeted therapies to treat vulvar cancers. These drugs do not have the same kind of side effects as traditional chemo drugs do. So far, the drugs cetuximab and erlotinib have been tried and doctors have reported some success in a few patients. Sometimes cetuximab is combined with cisplatin chemotherapy for treatment. Further studies of these drugs are needed.

Combining surgery, radiation therapy, and chemotherapy

Clinical trials are underway to determine the best way to combine surgery, radiation therapy, and chemotherapy. For example, these trials will provide information about whether certain groups of patients benefit from radiation after surgery and whether patients with cancer that has spread to lymph nodes benefit from chemotherapy or pelvic radiation therapy.